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Radio presenter Rachel Horne on her journey to dry running with the help of physio Emma James.

Rachel Horne, newsreader and Chris Evan’s co-presenter on Virgin Radio UK. 

“My friend Jools recommended I visit Emma James Physio, a specialist pelvic floor physiotherapist at her clinic at Champneys, Tring after I announced I was going to do The London Marathon. (Rachel was cajoled live on the Virgin Radio breakfast show by Vassos, Chris and the team back in November 2019!).

I’d never attempted a long run without desperately needing the loo.

“As soon as I’d said yes to the marathon, I panicked that my weak pelvic floor wasn’t up to it and was going to stop me from running the 26 miles. I’d done the odd bit of cross country before at school and outdoor fitness boot camps but never attempted such a distance or gone for a long run without desperately needing the loo!

rachel

“In fact, I used to dread it in summer when I did the Boot Camps and would always wear an incontinence pad, tie my hoodie around my waist and take a towel to sit on in the car on the way home in case the inevitable happened.

“I had three children in just over three years; carrying them put extra pressure on my pelvic floor and then I had complicated births giving me second and third-degree tears which weakened my pelvic floor further and the reason I leak when I run. 

“I hadn’t got round to doing anything about it mainly because as one of many 30 and 40-something women who are always busy looking after other people, fixing ourselves goes right down the list of priorities.

It’s almost a badge of honour for women to say they leak.

“I think I’d also just fallen into the trap of just accepting bladder leakage was normal. It’s almost a badge of honour for women to say they leak whether that’s when they run, get on a trampoline with the kids, or sneeze. Everyone laughs about it. You see it on TV adverts where women laugh about having the condition and it’s so normalised that women think they should say nothing and just use an incontinence pad whenever we leave the house.

Emma is a force for good.

“Emma is a force for good. My first visit to her was almost like a therapy session. She took the time to ask me about myself and encouraged me to tell her my story, giving me a safe space to open up. When she said she could fix my bladder leakage I felt like a weight had been lifted off my shoulders. She was wonderful.

“She helped me to realise it’s NOT OK to leak and made me see that unless I took steps to strengthen my pelvic floor, my leakage would just get worse, particularly as I approached the perimenopause and menopause.

“Because of the challenge I was facing, training for the marathon in a little over five months, Emma suggested a multi-pronged attack although I was relieved to hear I didn’t need to have an internal exam, which I know puts many women off sorting out their bladder problems, as I don’t have a prolapse.

“Through Emma’s clinic, I’ve used a combination of pelvic floor strengthening exercises, tried pelvic floor trainer Pelviva, had sessions on the PelviPower chair, and used Secret Whispers and my bladder leakage has dramatically reduced.

Leaking has definitely improved my general wellbeing.

“After just six weeks of support, I was dry after the first mile which was never the case before as I always leaked just after I started to run. Recently, I managed 5km (3.5 miles) over hilly terrain and was completely dry at the end of the run which felt like such a massive, massive achievement. Leaking less has definitely improved my general wellbeing too as I feel more like myself again. I now no longer need to wear a pad EVERY SINGLE DAY and only keep one on for exercise in the unlikely case I might leak. 

I no longer need to wear a pad every day.

“Now due to the Coronavirus, The London Marathon is rightly postponed but I do hope to run it later in the year. Once I’ve done that, I don’t think I’ll ever do another marathon ever again! However, I’m planning to continue running between 5 and 10km on a regular basis to get that time to think, feel energised, enjoy the fresh air, and release those endorphins and will be able to do so without always leaking which is just amazing!”

rachelhair

 

 

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Why we should Exercise

Adults should do some type of physical activity every day. Any type of activity is good for you. The more you do the better. The following advice is from NHS England.

Adults should:

  • aim to be physically active every day. Any activity is better than none, and more is better still
  • do strengthening activities that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week
  • do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week
  • reduce time spent sitting or lying down and break up long periods of not moving with some activity

What counts as moderate aerobic activity?

exercisingModerate activity will raise your heart rate, and make you breathe faster and feel warmer. One way to tell if you’re working at a moderate intensity level is if you can still talk, but not sing. Examples of moderate intensity activities include brisk walking, water aerobics, riding a bike, dancing, doubles tennis, pushing a lawn mower, hiking.

What counts as vigorous activity?

Vigorous intensity activity makes you breathe hard and fast. If you’re working at this level, you will not be able to say more than a few words without pausing for breath. In general, 75 minutes of vigorous intensity activity can give similar health benefits to 150 minutes of moderate intensity activity.

riding-a-bikeMost moderate activities can become vigorous if you increase your effort.

Examples of vigorous activities include jogging or running, swimming fast, riding a bike fast or on hills, sports, skipping, aerobics, martial arts.

 

What activities strengthen muscles?

muscle-trainingTo get health benefits from strength exercises, you should do them to the point where you need a short rest before repeating the activity. It is best to get a chartered physiotherapist or qualified personal trainer to advice you on this.

There are many ways you can strengthen your muscles, whether you’re at home or in a gym and this includes lifting weights, using resistance bands and body weight exercises (such as press ups).

Always gain advice from a qualified professional before starting a new exercise programme or if there is a change in your health status.

How we can help

lisa
Stay Healthy
Lisa

Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Pilates for Men

It is 2020, and we know people now realise that Pilates isn’t just for women. You can almost hear the collective sigh of relief from us physios – partly because we can finally (almost) move on from the long-overplayed “so you think Pilates is a girls’ thing? well then let me tell you about Joseph Pilates…” rhetoric, but mainly because we are finally seeing the benefits of Pilates being recognised by the wider public and how it is becoming increasingly common across different demographics.

While Pilates is hardly a gender-specific/focused exercise routine, it is worthwhile mentioning how its application can benefit men nonetheless. From the amateur weekend warrior to professional athletes, principles of Pilates have been firmly incorporated in their weekly schedules, training, and recovery sessions; here are some of the reasons why.

kelvin-on-reformerFlexibility

Reformer Pilates involves various three dimensional movements, working the length and elasticity of your muscles and encourages your joints to be able to move through the biggest possible range, thus reducing your likeliness of injury.

Improving Posture

The origin of most aches and pains is bad posture. Every Pilates exercise you do will have a postural benefit due to the combination of challenging your strength and flexibility. Pilates will develop muscular balance in your joints which will improve your posture.

Core Strength

Your core is the combination of muscles that support your spine and torso, forming the foundation for all movements. A weak core causes instability and reliance on dominant muscles, which over time inhibits flexibility, reduce range of movement and ultimately cause injury. Pilates promotes core activation and engages all of your postural muscles leading to more stable and powerful movements. Consider a tennis player who has to return a powerful serve while moving and contorting their bodies: for them to be able to generate the adequate force on their return they must have good core strength.

Addressing Muscular Imbalances

Some of your muscles, like those that dominate your daily movements, are stronger than others, and a huge emphasis of Pilates is focusing on those muscles that don’t typically get a lot of attention. Pilates requires you to consciously move in certain ways to challenge muscles that you don’t hit while lifting heavy weights in the gym, running or in your daily life.

Awareness, Concentration and Focus

mens-health-pilatesPilates forces you to pay attention to your body, you’ve got to focus on your breath while working through each movement and concentrating on proper form and activating the correct muscles. This significantly enhances your body control and awareness (Thus improving your balance as well) which are both fundamental skills to maintaining sporting performance.

The reason that Pilates is fundamentally such an all-encompassing, well-rounded approach to exercise and body movement is precisely the reason why it could – and should – be incorporated in most people’s routine. Its minimal requirement of equipment and space makes it a very versatile option for a quick, mobile workout, and the gains from Pilates almost always translate across to other aspects of one’s wellbeing as well. More and more men are slowly realising its benefit and the conversations with their physios are certainly a lot different to what it was a few years ago.

It is 2020. It is no longer a misunderstanding, and it is no longer just a trend.

kelvinKelvin

Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

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Tendon Pain Treatment and Management

The best part about tendon rehab is you need to facilitate your load to optimal levels, so it doesn’t mean complete cessation of exercise! Tendon rehab is fundamentally based around loading the affected musculotendon unit, so strengthening exercises are key. Research shows best outcomes are associated with a long term (average 12 weeks), progressive and individualised loading programme. So as long as you put the hard graft into your rehab; you’ll go the extra mile!

There are other significant factors that will contribute to your management; such as foot and ankle biomechanics, BMI, psychosocial factors as well as other co-morbidities. As Kelvin stated in our previous blog post, each case of tendon pain is unique and is tailored to you as the individual.

So, what is the norm for Tendon Pain?

Due to the makeup of the tendon fibres and what their role is, it takes either a dramatic change in your load or a build up in load that exceeds your capacity over time to elicit a painful response. This may cause an inflammatory response for an acute change and/or structural change in a more chronic period of excessive loading. Either way, there will be an element of pain that is overriding in either your day-day activities or exercise-based activities.

So, What do we do?

You stop doing what hurts, dur? Well, with tendon pain it isn’t as straight forward, and that’s good news for you! Why? Because it doesn’t mean you have to completely stop all forms of activity. Our aim is to keep the healthy or injured part of the tendon active within our desirable limits and with suitable progressions in activity and exercise; our tolerance will improve over time!

So now we come onto the million-dollar question, what is the right amount of pain?

The criteria for tendon related acceptable pain is really straight forward, we take a subjective interpretation of your pain and provide scores of optimal, acceptable and undesirable intensities of pain. The presence and/or duration of symptoms after a reaction are also monitored and fall into the same categories. Remember, your pain is unique to you, as well as your exercise tolerance – this is all considered when your therapist constructs your rehabilitation programme.

adamSo don’t panic, tendon pain isn’t as debilitating as it seems. With patience and commitment, we will get you back to your goals, and back even stronger than before!

Adam

Blog post by Adam
Senior Physiotherapist at Emma James Physio

The upward surge in sports injuries around this time of the year

As the winter months slowly start to take over our skies, the balmy holidays in July and August already feel like a distant memory; what that also means for a lot of us is that we’re back in full swing with our gym routines, running trails, contact sport training and games – casual and professional athletes alike – and perhaps preparing for our next marathon/half-marathon.

Interestingly, we as Sports Physios tend to see an upward surge in sports injuries around this time of the year. And sometimes, as a figure of speech, we can even predict certain months being more “hip/knee/ankle injury dominant”, depending on whether there is a prominent sports events coming up e.g. London Marathon, or a finals series. In those months, we are bound to see and treat a few people with sore ankle tendons or painful knee tendons.

…but why is that?

Today I’m hoping to provide you with a little insight to how we as physios answer that question.

Tendons mostly are the thick, fibrous connective tissue that links a particular muscle to a bone, and is the main structure that converts a muscle contraction into an actual body movement. It is primarily made up of collagen tissue, and this tissue can be an incredibly robust, “workhorse” structure – being able to absorb impact, withstand multi-directional forces, convert muscle energy into movement, and generate power + velocity pertaining to our chosen sport.

However, tendons do have a major character flaw: they are very, very sensitive to change. Which means any drastic changes to one’s training routine – simply termed as Load in Sports Science – can have an irritating effect on the tendon structure, eventually leading to pain. Load, as we know, can be measured in a few ways:

  • Frequency: How often the training takes place e.g. How many runs per week?
  • Intensity: How hard the training session(s) is, e.g. How fast you’re running
  • Volume: How much the person is doing in a particular session, e.g. How far you’re running

When there is a sudden, drastic increase in load – or an “upward spike” – the collagen structure of the tendon is unable to cope with these changes, and can often begin an inflammatory process, leading to collagen/tendon breakdown, and in severe cases, loss of structural integrity. Broadly speaking, this is when the person begins to feel a persistent pain during and/or after the training, and the performance/output is no longer as well as before. Conversely, tendons also adapt to a decrease in load – or we refer to as “deloading” – whereby the collagen structure adapts to a lesser training load/regime, and in time is no longer at the capacity of its previous training intensity. So if we were to put two and two together: a deloading phase during our summer holidays/off-season followed by an upward spike around this time of the year…it’s not hard to see why some of us are getting aches and pains!

Luckily, most of the time these changes are not permanent, and tendons generally do respond well to treatment and rehabilitation. This is where the expertise of your physio comes in – we can determine the extent/severity of your presenting tendon injury, provide any immediate treatment that is necessary, but more importantly go through the details of your training routine and carefully making adjustments to it. This ensures that we are gradually rebuilding your tendon strength properly, as well as preventing it from further irritation and breakdown. Such is the nature of tendon injuries, there is no one-size-fits-all, and each case is treated in accordance to its specific needs.

All the physios at Emma James have had the privilege to work with (and currently so) athletes at various levels, and therefore are very experienced in dealing with tendon injuries.

kelvinShould you have any doubts about your training, be sure to contact us as we would love to help. Just imagine: us making your marathon training (actually) enjoyable!

Kelvin
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Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

Benefits of working with a Personal Trainer

There are many reasons why having a Personal Trainer (PT) can benefit you, people of all ages and abilities. See better results by living a happier more active lifestyle.

A Personal Trainer will help build a unique training plan for each individual, which can easily be adapted and adjusted. Exercises can be regressed or progressed depending on the level of fitness, injury, results driven, time and if having an ‘off day’.

Top 5 Benefits

1. Faster and Better results

person-training-1Having a Personal Trainer will make sure you stick to your programme and push you to your limits during a workout session. Often when you work out solo you can become distracted and don’t push yourself as much. Time is always an excuse as not to work out but having a PT can adjust programs so they are just as affective no matter what the length of time you have available.
By pushing your boundaries, you will see faster results, this could be weight loss, toning up, cardio/fitness level or strength.

2. Fat loss and Muscle Gain
This is not everyone’s main goal but for 80% off people hitting the gym it is. Having a Personal Trainer, they know the right exercise each individual should be doing to achieve their goals. A mixture of weight training to gain muscles and become stronger and cardio to get fitter and leaner

3. Reduce chance of injury
A Personal Trainer will teach proper form and technique, which will prevent injury. Injuries can easily occur from not warming up properly or doing exercises incorrectly.

4. Establish a lifestyle habit and routine
A Personal Trainer can help motivate and encourage to create new habits. Once a routine is established it is easier to stick to, making it part of your lifestyle will make it easier to achieve results. Exercise and diet are all about consistency if you want to see those results.

5. They fit into your schedule
We all have busy lives and lots going on the beauty of a Personal Trainer is that they will adapt their time to fit in with you. So if you need an early morning or late evening workout a PT will be there.

person-training-outside6. Flexibility on Location
Many do not like working out in a gym as it can be crowded and over whelming. A Personal Trainer can change the location of any workout from either the gym, a home work out or even outside.

7. They can help with specific goals – an Event
As well helping set realistic goals a Personal Trainer can help set a training plan and train for specific event whether this be a run, triathlon, swim or a sporting event etc. With events you need to reach a certain level of fitness to be able to compete and stay injury free.

8. Mentor / Mental Health
Exercise realises endorphins which are ‘happy hormones’ they can help make you feel good physically and mentally. A Personal Trainer can help motivate you when you are suffering from mental health issues, they can help keep you on course to release the greatest number of endorphins. This in turn helps with a person’s overall wellbeing. A PT cares about how stressed you are, they will listen to you, they want to give you the best results which can be impacted on how you are feeling.

If this sounds interesting and you need that extra push why not call or email Emma James Physio to find out more….
reception@ejphysio.co.uk
01442 870686pippa

Pippa
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Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

“I’ve got that Plantar Fa…something”

At some point, we’ve all experienced some kind of pain in the foot, or know of someone who is currently experiencing/complaining about persistent foot pain. Perhaps it was around the time we decided to get back to the gym for six weeks. Perhaps it was after a major hike up in the Lake District. Perhaps it is just the nature of our job has a bartender. Quite often, we then get told – or even self diagnose – that it’s something called Plantar fasciitis. But what exactly is Plantar fasciitis?

The Plantar Fascia is a thick, strong band of connective tissue in the base of the foot, roughly spanning from the heel to just before our toes. Because of its structure, it acts as a shock absorber, provides structural supports for our arches; and mechanically acts as a spring when we walk and run. Plantar Fasci-itis is the name of the condition when this structure is irritated and inflammed, thus causing the persistent, and often flagrant pain.

What causes plantar fasciitis?

Plantar fasciitis often occurs with a combination of physical, environmental, and social/work factors all impacting on the structure of the foot. Some of these are listed below:

  • Altered/poor gait (walking) biomechanics
  • Weakness in hip, knee, and/or foot muscles
  • Repetitive strain on the soft tissue
  • Recent change in physical workload (Predominantly overloading)
  • Poor/uncomfortable footwear

Treatment and Management

shutterstock_57382018The initial goal in managing plantar fasciitis is to reduce pain and inflammation. Your physiotherapist would be able to provide some manual treatment to help begin the recovery process. But it is also important to then assess and examine all these factors mentioned above in order to get to the root of the issue, and being able to prescribe the most appropriate management plan. This may include some stretching/strengthening exercises, modifications to your activities/daily schedule, and in some cases recommending extra assistance, such as an orthotic.

gait-scanAll our physiotherapists at Emma James are trained to assess any biomechanical issues, whilst the clinic is also equipped with purpose-specific pressure pads to perform a detailed gait analysis.

If this is something that you needed help with to get back to your work, your training, or even just to be pain-free, come and see our team of experts at Emma James Physio and we would love to help you!

kelvinKelvin

Kelvin Leung, Sports Physiotherapist
Emma James Physio

Knee Injury and risk of Osteoarthritis

A recent study published in the BMJ analysing the risk of developing knee osteoarthritis (OA) after knee trauma analysed over 1 million patients.

The risk of developing knee OA after ACL injury was 4 x higher compared to the non- injured knee or non- injured knee.

A meniscal (cartilage) injury and combined ACL/ meniscal injury as associated with 6x higher risk of developing OA.

Key messages:
1. The IMPORTANCE OF KNEE INJURY PREVENTION PROGRAMMES (strengthening).

2. The IMPORTANCE OF STRENGTHENING AFTER INJURY TO PREVENT or DELAY KNEE OA DEVELOPING.

apos therapy boots

If conventional physiotherapy alone is not being effective at reducing pain and improving function apos therapy is the next non- surgical option- customised and calibrated footwear to reduce pain and improve muscle control.

You can also book a free consultation, to see if Apos Therapy could work for you.

EJP_Book_your-Appointment-with-us-today

More Information:

lisa

Lisa
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Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

 

The importance of rest and recovery when training

This should be the easy part of our training but it tends to be the most neglected part. Rest is just as important as the actual training itself.

In order to see an improvement in performance, our body needs to be exposed to stresses, the body then needs time to adapt to the stresses and this is the period of recovery. Rest and recovery are vital in the prevention of injuries.

7 Important guidelines to consider after training which will improve recovery:

stretching-rest-and-recovery

1. Cool Down and Stretch
After exercise it is important to cool down to bring your body temperature back down and also to stretch the muscles that you have worked.

2. Replace fluids
It is important to replace your fluids after training as you lose a lot of salts whist training.

3. Nutrition
It is important to make sure you eat properly after training because this will boost your recovery.

4. Rest
It is essential to put your feet up and rest!!

5. Massage or self-massage
I would recommend a regular massage when you are in training however another option is to use a foam roller or tiger tail and do it yourself.

6. Sleep
Sleep is essential for recovery. When we are sleeping our bodies produce a growth hormone which plays an important part in our tissue growth and muscle repair.

7. Listen to your body
Most importantly!!! If you are tired your body is telling you to rest, so do it.

kerry-gym-manager
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Happy Training & Resting Buddies!
Kerry
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Blog Post by Kerry
Group Gym Manager & Personal Trainer

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